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European Journal of Nuclear Medicine... Jan 2019F-FDG PET/CT is an emerging technique for diagnosis of cardiac implantable electronic devices infection (CIEDI). Despite the improvements in transvenous lead extraction... (Observational Study)
Observational Study
PURPOSE
F-FDG PET/CT is an emerging technique for diagnosis of cardiac implantable electronic devices infection (CIEDI). Despite the improvements in transvenous lead extraction (TLE), long-term survival in patients with CIEDI is poor. The aim of the present study was to evaluate whether the extension of CIEDI at F-FDG PET/CT can improve prediction of survival after TLE.
METHODS
Prospective, monocentric observational study enrolling consecutive candidates to TLE for a diagnosis of CIEDI. F-FDG PET/CT was performed in all patients prior TLE.
RESULTS
There were 105 consecutive patients with confirmed CIEDI enrolled. An increased F-FDG uptake was limited to cardiac implantable electrical device (CIED) pocket in 56 patients, 40 patients had a systemic involvement. We had nine negative PET in patients undergoing prolonged antimicrobial therapy (22.5 ± 14.0 days vs. 8.6 ± 13.0 days; p = 0.005). Implementation of F-FDG PET/CT in modified Duke Criteria lead to reclassification of 23.8% of the patients. After a mean follow-up of 25.0 ± 9.0 months, 31 patients died (29.5%). Patients with CIED pocket involvement at F-FDG PET/CT presented a better survival independently of presence/absence of systemic involvement (HR 0.493, 95%CI 0.240-0.984; p = 0.048). After integration of F-FDG PET/CT data, absence of overt/hidden pocket involvement in CIEDI and a (glomerular filtration rate) GFR < 60 ml/min were the only independent predictors of mortality at long term.
CONCLUSIONS
Patient with CIEDI and a Cold Closed Pocket (i.e., a CIED pocket without skin erosion/perforation nor increased capitation at F-FDG PET/CT) present worse long-term survival. Patient management can benefit by systematic adoption of pre-TLE F-FDG PET/CT through improved identification of CIED related endocarditis (CIEDIE) and hidden involvement of CIED pocket.
Topics: Aged; Defibrillators, Implantable; Endocarditis, Bacterial; Female; Fluorodeoxyglucose F18; Humans; Male; Mortality; Pacemaker, Artificial; Positron Emission Tomography Computed Tomography; Prosthesis-Related Infections; Radiopharmaceuticals
PubMed: 30196365
DOI: 10.1007/s00259-018-4142-9 -
Clinical & Experimental Ophthalmology Aug 2021To describe ocular adverse events and retinal changes during fibroblast growth factor receptor (FGFR) inhibitor (AZD4547) anticancer therapy.
Increased interdigitation zone visibility on optical coherence tomography following systemic fibroblast growth factor receptor 1-3 tyrosine kinase inhibitor anticancer therapy.
BACKGROUND
To describe ocular adverse events and retinal changes during fibroblast growth factor receptor (FGFR) inhibitor (AZD4547) anticancer therapy.
METHODS
This is a sub-study examining ocular adverse effects from AZD4547 therapy (single-centre, open-label, single arm phase II clinical trial). Comprehensive ocular examinations were performed 3 weekly in 24 patients. Macular optical coherence tomography (OCT) scan (30 × 25 ) was obtained at each visit and OCT parameters [central 1 mm retinal thickness (CRT) and total macular volume in central 6 mm] extracted. OCT scans were subdivided into outer (ELM to RPE) and inner (ELM to ILM) layers to compare outer and inner retinal changes.
RESULTS
In 24 patients, AZD4547 was associated with eyelash elongation (n = 5, 21%) and punctate corneal erosion (n = 2, 8%). One patient developed clinically significant posterior capsular opacification during the study. OCT data were available in 23 patients, retinal changes ranged from an asymptomatic increased visibility of the interdigitation zone (IDZ) (n = 10, 43%) to multilobular subretinal fluid pockets (n = 5, 22%), which was associated with mild visual acuity loss. In a subset of patients (n = 9) with pre-AZD4547 dosing OCT baseline, CRT increased by mean (SD) of 9 (4) μm in those with IDZ change only compared with 64 (38) μm in those with other retinal changes. Retinal changes tended to be bilateral, self-limiting and improved over time without medical intervention.
CONCLUSIONS
The ocular signs and symptoms did not result in dose cessation. Posteriorly, FGFR inhibition leads to outer retinal changes ranging from increased visibility of IDZ to distinct, multiple fluid pockets.
Topics: Humans; Protein Kinase Inhibitors; Receptor, Fibroblast Growth Factor, Type 1; Retina; Tomography, Optical Coherence; Visual Acuity
PubMed: 33934469
DOI: 10.1111/ceo.13940 -
Journal of Family Medicine and Primary... Oct 2020The occupational environment influences oral health to a greater extent. The unique environment in the steel factory might influence oral health and oral health-related...
INTRODUCTION
The occupational environment influences oral health to a greater extent. The unique environment in the steel factory might influence oral health and oral health-related quality of life of its workers, especially those who are exposed to its environment.
AIM AND OBJECTIVES
To determine oral health status and Oral Health-Related Quality of Life among production line and administration workers of a steel factory and assess their relationship with occupation exposure.
METHOD
A cross-sectional study was conducted among 533 production line and 517 administration workers of the steel factory aged 31-60 years using simple random sampling. The collected data includes information on demographic factors, adverse habits of the study subjects, and oral health-related quality of life using Oral Health Impact Profile-14 (OHIP-14). The oral health status was assessed using the WHO oral health assessment form 2013.
STATISTICAL ANALYSIS
SPSS Version 20 was used for statistical analysis. A student -test was done to compare means.
RESULTS
The prevalence of dental caries is 62.5% in the production line and 74.9% in administration workers, and the prevalence of periodontal status is 91.6% and 74.8%, respectively. The mean of OHIP-14 was 2.13 ± 0.73 in the production line and 2.33 ± 0.77 in administration workers. All domains of OHIP-14 were found to have high statistical significance with dental caries, periodontal pocket depth, loss of attachment, oral mucosal lesions, dental erosion, and dental trauma in both study groups ( < 0.001).
CONCLUSION
OHIP-14 scores were related significantly with oral health status indicators in both study groups. The prevalence of the periodontal disease, oral mucosal lesions, and OHIP-14 scores was found to be significantly higher among production line workers.
PubMed: 33409207
DOI: 10.4103/jfmpc.jfmpc_877_20 -
HeartRhythm Case Reports Nov 2023
PubMed: 38023679
DOI: 10.1016/j.hrcr.2023.08.010 -
Journal of Cardiology Cases Jan 2021An 80-year-old man with a history of dilated hypertrophic cardiomyopathy received a dual-chamber pacemaker for sick sinus syndrome and atrioventricular block in February...
An 80-year-old man with a history of dilated hypertrophic cardiomyopathy received a dual-chamber pacemaker for sick sinus syndrome and atrioventricular block in February 2010. On May 30, 2019, he developed pocket erosion, with streaks of pus exuding from the pocket. The pacemaker generator was removed, although both capping leads were left buried under the skin, and a leadless pacemaker was implanted into the right ventricular (RV) apex the next day. Blood and pus cultures on July 15, 2019 indicated methicillin-resistant (MRSA). The patient was transferred to our hospital for simultaneous removal of both devices in August 2019. The RV lead and right atrial lead were extracted using a laser sheath and a mechanical sheath. A 23 Fr MICRA® sheath was inserted from the right femoral vein to accommodate an 8.5 Fr Agillis sheath. An Osypka LASSO snare catheter was advanced through the sheath to catch the distal aspect of the MICRA® body. Finally, the MICRA® device was completely removed through the sheath. Culture results for the lead tip and MICRA® were both MRSA positive. This is the first report of late-phase simultaneous infection of abandoned leads and implanted leadless cardiac pacemaker extraction. < Leadless pacemakers are becoming increasingly popular in high-risk patients due to no lead-associated complications. As a result of the incomplete removal, the remaining leads caused a drug-refractory blood stream infection, which secondarily infected the MICRA® device. Thus, an insufficiently treated pocket infection resulted in persistent methicillin-resistant bacteremia in this case.>.
PubMed: 33437338
DOI: 10.1016/j.jccase.2020.09.005 -
BMC Oral Health Apr 2024Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related...
BACKGROUND
Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related behaviours. The study examined oral health, related behaviours, and perceived stress in dry-mouth patients and compared them to matched controls without mouth dryness.
METHODS
Information about 182 dry-mouth patients and 302 age- and sex-matched subjects was retrieved. Three dry mouth groups: xerostomia, Sicca syndrome and Sjögren's syndrome, were formed based on patient self-reported and objectively assessed symptoms. The World Health Organization's Oral Health for Adults and Perceived Stress Scale (PSS-10) questionnaires inquired about sociodemographic characteristics, oral health-related behaviours, and self-perceived stress. Clinical oral health assessments included: caries experience measured as total numbers of decayed (DS), missing (MS), filled surfaces (FS), number of remaining teeth, erosive tooth wear and extent of periodontal pocketing. Data were analyzed using bivariate and multivariable tests.
RESULTS
The dry-mouth participants had higher mean (SD) DMFS scores than their matched controls: xerostomia patients vs. controls: 74.6 (34.4) and 66.3 (35.4), Sicca syndrome patients vs. controls: 88.3 (34.0) and 70.1 (33.9), and Sjögren's syndrome patients vs. controls: 95.7 (31.5) and 74 (33.2). In comparison to controls, individuals with Sicca and patients with Sjögren's syndromes had lower mean (SD) number of remaining teeth, 15.9 (10.1) vs. 21.7 (8.4) and 13.8 (10.0) vs. 20.1 (9.2), and a lower mean (SD) extent of periodontal pocketing, 20.7 (28.6) vs. 41.1 (31.0), and 21.2 (24.1) vs. 34.8 (34.2), respectively. Xerostomia, Sicca syndrome and Sjögren's syndrome patients had higher odds of using fluoridated toothpaste; OR 1.8 (95%CI 1.1-2.9), OR 5.6 (95%CI 1.7-18.3) and OR 6.9 (95%CI 2.2-21.3), respectively. Participants with Sjögren's syndrome had lower odds of the last dental visit being within the last year; OR 0.2 (95%CI 0.1-0.8).
CONCLUSIONS
Dry-mouth patients had higher caries experience and fewer teeth than comparison groups but a lower extent of periodontal pocketing. Even though more participants with dry mouth used fluoridated toothpastes, their oral health-related behaviours were not optimal.
Topics: Adult; Humans; Sjogren's Syndrome; Oral Health; Cross-Sectional Studies; Xerostomia; Periodontal Pocket; Dental Caries; Stress, Psychological; Psychological Tests; Self Report
PubMed: 38622697
DOI: 10.1186/s12903-024-04224-7 -
Anais Da Academia Brasileira de Ciencias 2022The majority of ornithogenic soils studied in Antarctica focus on the influence of penguins, wherever little reports evaluated the influence of flying birds on soil...
The majority of ornithogenic soils studied in Antarctica focus on the influence of penguins, wherever little reports evaluated the influence of flying birds on soil genesis. This study aimed to characterize the morphologic, chemic, physic, mineralogic, and micromorphologic ornithogenic soil pockets influenced by flying birds in Snow Island, Maritime Antarctica. Fifteen soil pockets were selected, described, sampled and analyzed, these sites constitute the main areas with intense long-term terrestrial biological activity in Snow Island. In order to investigate the impact of phosphatization, we compared the soil pockets with the surrounding soils and soils affected by penguins. Zone of phosphatization have a high concentration of P, K, and Ca. The XRD patterns for the clay fraction of ornithogenic soils show that phosphate minerals are the main crystalline phases (leucophosphite, minyulite, fluorapatite, and apatite). We show that even under typical periglacial conditions, sites influenced by flying birds present active chemical weathering processes. The phosphatization release exchangeable bases and accelerate mineralogical and micromorphological transformations in soils. Under the current global warming trend and expected sea-level rise, the ornithogenic environments are susceptible to accelerated erosion rates and a great part of these hotspots may be lost for the open sea.
Topics: Animals; Antarctic Regions; Birds; Soil
PubMed: 35170669
DOI: 10.1590/0001-3765202220210595 -
The Journal of Clinical Pediatric... 2018To compare dental caries and oral findings in patients affected by different types of Cerebral Palsy (CP). (Comparative Study)
Comparative Study
OBJECTIVE
To compare dental caries and oral findings in patients affected by different types of Cerebral Palsy (CP).
STUDY DESIGN
This cross-sectional study involved 120 children and adolescents with a diagnosis of CP. WHO diagnostic criteria were used to determine DMFT (caries diagnosis), the pocket depth and attachment level (periodontitis diagnosis). Additionally, the study evaluated dental erosion, traumatic dental injuries, treatment needs index (TNI), oral habits, malocclusions, gingival overgrowth, and dental fluorosis.
RESULTS
The most frequent CP type was spastic (62.5%), followed by mixed (18.3%), ataxic (10%), and athetoid (9.1). Patients affected by mixed CP showed a higher prevalence in decayed, DMFT index and TNI compared with the other types of CP (p<0.05). The frequency of malocclusion in the clinical evaluation was 87.5% and in plaster models was 49.2%.
CONCLUSIONS
Dental caries was an important issue in mixed and athetoid CP groups. Oral habits and malocclusions were the most significant oral health problems in individuals with CP.
Topics: Adolescent; Cerebral Palsy; Child; Cross-Sectional Studies; DMF Index; Dental Caries; Female; Humans; Male; Malocclusion; Oral Hygiene
PubMed: 29360427
DOI: 10.17796/1053-4628-42.1.11 -
Operative Neurosurgery (Hagerstown, Md.) Aug 2017Deep brain stimulation is increasingly used to treat a variety of disorders. As the prevalence of this technology increases, greater demands are placed on neurosurgical...
BACKGROUND
Deep brain stimulation is increasingly used to treat a variety of disorders. As the prevalence of this technology increases, greater demands are placed on neurosurgical practitioners to improve cosmetic results, maximize patient comfort, and minimize complication rates. We have increasingly employed subpectoral implantation of internal pulse generators (IPGs) to improve patient satisfaction.
OBJECTIVE
To determine the complication rates of subpectorally placed IPGs as compared to those placed in a subcutaneous location.
METHODS
We reviewed a series of 301 patients from a single institution. Complication rates including infection, hematoma, and lead fracture were recorded. Rates were compared for subcutaneously and subpectorally located devices.
RESULTS
Of the records reviewed, we found 301 patients who underwent 308 procedures for initial IPG implantation. Of these, 275 were subpectoral IPG implantation, 19 were infraclavicular subcutaneous implantation, and 14 were subcutaneous implantation in the abdomen. A total of 6 IPG pocket infections occurred, 2 subpectoral and 4 infraclavicular subcutaneous. Of the IPG infections, 2 of the infraclavicular subcutaneous devices had associated erosions. Two patients had their devices relocated from a subpectoral pocket to a subcutaneous pocket in the abdomen due to discomfort. Two patients in the subpectoral group suffered from hematoma requiring evacuation. Two patients in the infraclavicular subcutaneous group had lead fracture occur.
CONCLUSIONS
Subpectoral implantation of deep brain stimulation IPGs is a viable alternative with a low complication rate. This technique may offer a lower rate of infection and wound erosion.
Topics: Aged; Cosmetics; Deep Brain Stimulation; Electric Power Supplies; Electrodes, Implanted; Essential Tremor; Female; Humans; Longitudinal Studies; Male; Middle Aged; Parkinson Disease; Patient Satisfaction; Pectoralis Muscles; Retrospective Studies; Treatment Outcome
PubMed: 28838110
DOI: 10.1093/ons/opx018 -
Quintessence International (Berlin,... 2021The extraction of a tooth with root resorption can be a complicated procedure and can result in the removal of a significant amount of alveolar bone. In the anterior...
The extraction of a tooth with root resorption can be a complicated procedure and can result in the removal of a significant amount of alveolar bone. In the anterior maxilla, esthetic rehabilitation of damaged sites with implant-supported crown could require multiple surgeries. Patients often ask for an alternative, and minimally invasive treatments are generally preferred. In this paper, a clinical case of implant-supported crown in a site affected by root resorption is described. Immediate implant was placed leaving some root fragments in the osteotomy site, thus avoiding invasive extractive surgeries. A minimally invasive flapless technique with a computer-guided implant placement procedure was used. After ?8 years, clinical and radiologic data were stable, gingival tissues around the implant appeared healthy, no dark translucency appeared through marginal gingiva around the implant, and there was no pathologic probing pocket depth ?or bleeding on probing. In the presence of root resorption and ankylosis, computer-guided surgery could be helpful to prepare a precise implant site through various tissues, such as partially resorbed root remnants. (Quintessence Int 2021;52:132-137; doi: 10.3290/j.qi.a45432).
Topics: Computers; Crowns; Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Maxilla; Tooth Extraction; Treatment Outcome
PubMed: 33433079
DOI: 10.3290/j.qi.a45432